Origins and Pathways to Drug Abuse

Research Findings from September, 1999 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the origins and pathways to drug abuse. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Relationship of ADHD, Depression and Non-Tobacco Substance Use Disorders to Nicotine Dependence in Substance-Dependent Delinquents

In a study of 367 male and female behaviorally disordered juvenile delinquents, 13 - 19 years old, Dr. Riggs and colleagues, Department of Psychiatry, University of Colorado School of Medicine, found that attention deficit hyperactivity disorder (ADHD) and major depression significantly contributed to the severity of nicotine dependence in adolescents diagnosed with a non-tobacco substance use disorder (SUD). ADHD was associated with earlier onset of regular smoking in males, and the severity of non-tobacco SUD was related to nicotine dependence severity in both boys and girls. Riggs, P.D., Mikulich, S.K., Whitmore, E.A., and Crowley, T.J. Drug and Alcohol Dependence, 54, pp. 195-205, 1999.

An Efficient Tool for Screening for Maladaptive Family Functioning in Adolescent Drug Abusers: The Problem Oriented Screening Instrument for Teenagers (POSIT)

Dr. Santisteban and colleagues from the Center for Family Studies, University of Miami School of Medicine, reported results of a study that examined the validity of the NIDA-developed POSIT questionnaire's 11-item Family functioning (problem area) scale in terms of degree to which the scale provides useful information regarding family functioning when the POSIT is administered to youths with behavior problems. Study participants were 135 boys and girls referred for drug treatment. Family functional status was determined by use of the general scale of the Family Assessment Measure (FAM) and the family scale of the Adolescent Drug Abuse Diagnosis (ADAD). Results indicate POSIT Family area problem scores can classify families correctly in terms of their functioning. Santisteban, D.A., Tejeda, M., Dominicis, C. and Szapocznik, J. American Journal of Drug and Alcohol Abuse, 25(2), pp. 197-206, 1999.

Attention Deficit Disorder and Substance Abuse

Timothy Wilens, M.D. and his colleagues at Harvard Medical School have shown that boys with attention deficit hyperactivity disorder (ADHD) who are treated with stimulants such as Ritalin are 84 percent less likely to abuse drugs and alcohol when they get older. Research showed that 75 percent of the non-medicated ADHD boys had at least one substance use disorder, compared to 25 percent of the medicated ADHD boys and 18 percent of the boys without ADHD. Researchers calculated that treating ADHD with stimulants was associated with an 84 percent reduction in risk of developing a substance use disorder. Rather than being concerned that boys with ADHD might be prescribed stimulant medication, scientists are now concerned when they are not. Appropriate treatment of ADHD appears to be quite helpful in preventing the later emergence of substance abuse in these vulnerable individuals with ADHD. The use of interventions in childhood to prevent the later emergence of substance abuse is a promising avenue for future research investigations. Biederman et al., Pediatrics, Vol 104(2), August 1999.

Adolescent Substance Abuse and Psychiatric Comorbidity: Timing and Gender

This study used state of the art evaluation methods to assess a large population based sample longitudinally, relating the development of drug abuse to pre-existing psychiatric disorder, other risk factors, and sex. Boys, but not girls, who later developed dependence or abuse began substance use at earlier ages. Disruptive behavior disorders and depression were both associated with higher rates and earlier onset of substance use and abuse in both sexes, while anxiety predicted later onset of smoking. Family history of drug problems was the strongest correlate of early onset. Boys and girls showed much similarity in the course of early drug use and abuse, and in associated psychopathology. This study is notable for the size of the sample and the sophistication of the methodology and analyses, enabling new observations about development and gender in regard to onset of substance use problems. Costello, E.J., Erkanli, A., Federman, E., and Angold, A. The Development of Psychiatric Comorbidity with Substance Abuse in Adolescents: Effects of Timing and Sex. Journal of Clinical Child Psychology, 28, pp. 298-311, 1999.

Juvenile Substance Abuse, Delinquency, and Internalizing Problems

Longitudinal data from the Pittsburgh Youth Study on boys ages 7 to 18 were analyzed to examine the co-occurrence of persistent substance use with other problem behaviors, including attention deficit hyperactivity disorder, delinquency, and internalizing problems such as depression and anxiety. Developmental differences were found. Among preadolescents, those who continued to use drugs tended to be persistent delinquents, and half this group displayed persistent internalizing problems as well. Among adolescents, a third persisted in drug use without manifesting other problems. Substance use was least common among those with persistent internalizing problems only. While delinquency and internalizing problems predicted persistent drug use in preadolescents, and persistent delinquency predicted substance use in adolescents, ADHD was not a predictor of persistent substance use or delinquency. This study adds important findings to the literature on comorbidity and prediction of substance use problems in youth. Loeber, R., Stouthamer-Loeber, M., and White, H.R. Developmental Aspects of Delinquency and Internalizing Problems and Their Association with Persistent Juvenile Substance Use Between Ages 7 and 18. Journal of Clinical Child Psychology, 28, pp. 322-332, 1999.

Deviance Training Among Anti-Social Boys

One of the key risk factors in the etiology of adolescent problem behavior is association with deviant peers. This study examined the early adolescent friendships of 206 Oregon Youth Study boys who were recruited into the study at ages 9-10 from schools in neighborhoods with high rates of delinquency. Data were collected again at ages 13-14 and 15-16. Results suggest that boys identified as anti-social in childhood showed poor-quality friendships at ages 13 -14 and were the most vulnerable to subsequent peer influences in the following two years. Boys with both poor-quality friendships and a high level of delinquency at age 13-14 escalated in delinquent behavior in the subsequent two years. This study suggests that problem behavior in early adolescence, on occasion, functions to initiate and establish friendships. This process of deviancy training is highly related to an adolescent metamorphosis, in that early patterns of antisocial behavior turn into drug abuse and other forms of problem behavior. Poulin, F., Dishion, T.J., and Hass, E. The Peer Influence Paradox: Friendship Quality and Deviance Training Within Male Adolescent Friendships. Merrill-Palmer Quarterly, 45(1), pp. 42-61, 1999.

Many Problem Behaviors Form Single Construct

This study explored whether multiple problem behaviors form a single construct and whether the developmental model of antisocial behavior (Patterson and colleagues) generalizes to the development of other problem behaviors. Longitudinal data obtained from 204 adolescents and parents support a single construct for problem behavior comprised of youth antisocial behavior, high-risk sexual behavior, academic failure and substance use. Further, the data support the developmental model of antisocial behavior. That is, families experiencing high levels of conflict are more likely to have adolescents who engage in an array of problem behaviors at a two-year follow-up. This relationship was mediated by low levels of parent-child involvement, poor parental monitoring, and association by the adolescent with deviant peers. Ary, D.V., Duncan, T. E., Duncan, S.C., and Hops, H. Adolescent Problem Behavior: The Influence of Parents and Peers. Behavior Research and Therapy, 37, pp. 217-230, 1999.

Family Processes and Deviant Peers Related to Wide Array of Problem Behaviors

This study used structural equation modeling to evaluate a model of family and peer influence on problem behaviors using longitudinal data obtained from 523 adolescents. The study found that families with high levels of conflict were less likely to have high levels of parent-child involvement. Such family conditions resulted in less adequate parental monitoring of adolescent behavior, making associations with deviant peers more likely. In turn, a lack of parental monitoring and association with deviant peers accounted for 46% of the variance in engagement in a variety of problem behaviors including substance use, antisocial behavior, academic failure, and risky sexual behavior. Although association with deviant peers was the most proximal social influence on problem behavior, parental monitoring and family factors (conflict and involvement) were key parenting practices that influenced this development process. Ary, D.V., Duncan, T.E., Biglan, A., Metzler, C. W., Noell, J. W., and Smolkowski, K. Development of Adolescent Problem Behavior. Journal of Abnormal Child Psychology, 27, pp. 141-150, 1999.

Association Between Hyperactivity and Executive Cognitive Functioning in Childhood and Substance Use in Early Adolescence

To determine whether deficient executive cognitive functioning (ECF) in association with high behavioral activity level increases the liability to substance abuse, researchers at the Center for Education and Drug Abuse Treatment (CEDAR) compared a high-risk (HR) group having fathers with a lifetime DSM-III-R diagnosis of a psychoactive substance use disorder with a low-average-risk (LAR) group whose fathers had neither psychoactive substance use disorder nor another adult Axis I psychiatric disorder. ECF and behavioral activity were measured using neuropsychological tests, activity monitor, diagnostic interview, and informant ratings when the subjects were 10 to 12 years of age. Alcohol, tobacco, and cannabis use were measured at 2-year follow-up. Findings indicate that at baseline the HR group had a significantly higher behavioral activity level and exhibited poorer performance on ECF tests than the LAR group. By early adolescence, HR subjects had a higher lifetime rate of tobacco and cannabis use and earlier age at onset of cannabis use. ECF capacity, but not behavioral activity level, predicted tobacco and cannabis use, total number of drugs ever tried, and severity of drug involvement. ECF accounted for additional variance beyond the effects of conduct problems on these outcomes. Whereas behavioral activity and ECF capacity in late childhood distinguishes HR from LAR youth, childhood ECF capacity is the more salient predictor of drug use in early adolescence. Aytaclar, S., Tarter, R.E., Kirisci, L., and Lu, S. Journal of the American Academy of Child and Adolescent Psychiatry, 38(2), pp. 172-178, 1999.

Investigation of Family Associations Between ADHD And Substance Use Disorders

This paper reports on findings using the family study method to test hypotheses regarding familial associations between attention deficit hyperactivity disorder (ADHD) and substance use disorders (SUD). The risk for ADHD did not differ by SUD family status, and the risk for SUD did not differ by ADHD family status, but each disorder was associated with a significantly increased risk for that disorder in family members. These findings are consistent with independent transmission of ADHD and SUD in families. However, the probands are young adolescents, and follow up is needed to see if an association emerges as they pass through the age of risk for SUD. Milberger, S., Faraone, S.V., Biederman, J., Chu, M.P., Wilens, T. Familial Risk Analysis of the Association Between Attention Deficit Hyperactivity Disorder and Psychoactive Substance Use Disorders. Archives of Pediatric and Adolescent Medicine, 152, pp. 945-951, 1998.

Initial Drug Opportunities and Transitions to First Use

Researchers at Johns Hopkins University examined initial opportunities to try selected drugs and transitions from first opportunity to first use of those drugs. Target drugs were marijuana, cocaine, heroin, and hallucinogens. Investigators examined sex and race-ethnicity differences in estimates of having a drug opportunity, and in the probability of progressing from having an opportunity to try a drug to actually using the drug. Self- report interview data collected for the National Household Surveys on Drug Abuse (NHSDA) from 1979 to 1994 were analyzed. Results showed that an estimated 51% of US residents have had an opportunity to try marijuana; comparative estimates for cocaine, hallucinogens, and heroin are 23, 14, and 5%, respectively. Among those who eventually used each drug, the vast majority made the transition from first opportunity to first use within 1 year. Males were more likely than females to have opportunities to try these drugs, but were not more likely than females to progress to actual use once an opportunity occurred. Time trends indicate recent increases from 1990 to 1994 in the estimated probability of using an illicit drug once an opportunity occurs, particularly for hallucinogens. This study sheds light on the epidemiology of the earliest stages of drug involvement in the USA. Van Etten, M.L., and Anthony, J.C. Comparative Epidemiology of Initial Drug Opportunities and Transitions to First Use: Marijuana, Cocaine, Hallucinogens and Heroin. Drug and Alcohol Dependence, 54(2), pp. 117-125, 1999.

Salivary Cortisol Responses in Prepubertal Boys: The Effects of Parental Substance Abuse and Association with Drug Use Behavior During Adolescence

Using male index cases from the CEDAR sample, researchers extended earlier observation of decreased cortisol reactivity to an anticipated stressor in sons of fathers with a substance use disorder (SUD), examined whether salivary cortisol underresponsivity in these high-risk prepubertal boys is an adaptation to the stress associated with having a father with a current SUD, and tested whether prepubertal cortisol underreactivity might be associated with subsequent drug use behavior during adolescence. Preadolescent salivary cortisol responses were examined in the context of risk-group status, paternal substance abuse offsets, and subsequent adolescent drug use behavior. The results confirmed a decreased salivary cortisol response to an anticipated stressor among sons of SUD fathers. Lower anticipatory cortisol levels were found for boys whose fathers had a current SUD or an SUD that ended between the boys' 3rd to 6th birthdays than for sons of control fathers. Lower preadolescent anticipatory cortisol responses also were associated with regular monthly cigarette smoking and regular monthly marijuana use during adolescence. The investigators concluded that cortisol hyporeactivity as an adaptation to chronic stress may be a key component of the intergenerational transmission of substance abuse liability. Moss, H.B., Vanyukov, M., Yao J.K., and Kirillova, G.P. Biological Psychiatry, 45(10), pp. 1293-1299, 1999.

Adolescent Drug Use and Adult Drug Problems in Women

The authors studied effects of variables assessed in adolescence on problems from drug use in adulthood in a community sample of women. One focus of this 13-year longitudinal study was moderators, which were hypothesized to exacerbate, or attenuate, the effects of early drug consumption on later drug problems. Potential moderators were sensation seeking, social conformity, academic orientation, parental support, depression, and drug problems in parents. Direct and mediating effects of these variables, as well as of drug consumption, were also evaluated. Results showed that most of the significant effects involved sensation seeking and social conformity. In addition, adolescent drug use significantly predicted adult polydrug problems. The effects of sensation seeking are consistent with the view that this variable reflects a sensitivity to drug use, which makes it more likely that drug use gets translated into drug abuse. Stacy, A.W., and Newcomb, M.D. Experimental and Clinical Psychopharmacology, 7(2), pp. 160-173, 1999.

Substance Use Established by Ages 14-15 Can Be Predicted by Academic and Social Behavior Displayed at Ages 7-9

This study examined early school-based academic and social variables with concurrent family conflict in predicting adolescent alcohol and other drug use. Children (N=335) were assessed initially in grades 2-4 on academic-related and social behavior variables using teacher ratings and rankings, peer nominations and ratings and direct observation of playground and classroom behavior. They were reassessed in grades 9-10, using interviews and questionnaires to determine the initiation and sequence of their use of alcohol, tobacco, marijuana and other hard drugs. In analyses done independently for males and females, lifetime abstainers were compared with adolescents who had used: (1) only alcohol; (2) alcohol and tobacco; (3) alcohol, tobacco and marijuana; and (4) all three plus other hard drugs. The drug classifications represent a normative-deviant continuum of adolescent drug use. Constructs were developed for early academic and social predictors as well as concurrent family conflict. Results showed more wide- ranging academic and social difficulties during elementary school for children falling at the more deviant end of the drug use continuum. For girls, the concurrent home environment appeared to moderate the effect of early academic and social variables. In effects, substance use established by ages 14-15 could be predicted by academic and social behavior displayed at ages 7-9. Hops, H., Davis, B., and Lewin, L.M. The Development of Alcohol and Other Substance Use: A Gender Study of Family and Peer Context. Journal of Studies on Alcohol, pp. 22-31, Supplement, 13 March 1999.

Prospective Study of Tobacco Smoking and Substance Dependencies Among Samples of ADHD and Non-ADHD Participants

This study focused on a group of young adults who as children had attention deficit/hyperactivity disorder (ADHD) and are at high risk for heavy use of licit and illicit substances. The study participants were part of a longitudinal study of the life histories of 492 children, one third who were identified as hyperactive in 1974 and whose childhood symptom ratings and medical histories were used to establish the Diagnostic and Statistical Manual of Mental Disorders (3rd edition. revised; DSM-III-R) ADHD diagnoses. The objectives of the study centered on describing (a) developmental history of tobacco use among ADHD and non-ADHD participants in a longitudinal sample, (b) the characteristic adult patterns of tobacco use from early adolescence through early adulthood, and (c) the relationship between ADHD status and tobacco and substance dependence outcomes. Adult data were obtained for 81% of the original 492 participants. Lifetime and current tobacco use were assessed from child, adolescent, and adult data, yielding eight measures of smoking status. The study showed that participants with and without ADHD did not differ in age of initiation to smoking, but there was a significant difference in the age smoking regularly began. By age 17, 46% of all participants with ADHD, as contrasted with 24% of the age-mate controls, reported smoking cigarettes daily. In adulthood, the proportion of participants with ADHD who were current smokers (42%) continued to exceed that of the age -mate controls. They were significantly different lifetime tobacco dependence rates - 40% compared to 19% for age mate controls. The rates for cocaine dependence were 21% for participants with ADHD and 10% for age mate controls. The rates for stimulants were 20% for participants with ADHD and 11% for age mate controls. Results were interpreted to support a possible link between ADHD treatment histories, and levels of tobacco smoking and tobacco dependence in adulthood. Lambert, N.and Hartsough, C. Journal of Learning Disabilities 31(6) pp. 533-544, 1998.

Cloninger's Constructs Related to Substance Use Level and Problems in Late Adolescence

Cloninger's constructs of novelty seeking, harm avoidance, task-reward dependence, and social reward dependence have been related to smoking and alcohol use in adolescence and adulthood. A study at Yeshiva University tested the role of these constructs as mediators related to substance use level and substance use problems. Participants were 1,225 adolescents with average age of 15.5 years. Structural modeling showed indirect effects for novelty seeking, harm avoidance, and task reward dependence, mediated through self-control; harm avoidance also had an inverse direct path to substance use level. Social reward dependence had a positive direct path to coping motives for substance use. Good self-control had inverse paths to negative life events and deviant peer affiliations; poor self-control had positive paths to negative life events and coping motives; and risk taking had positive paths to coping motives and peer affiliations. These findings suggest that substance abuse prevention programs should incorporate components focusing on beliefs about the functions of substance use and that treatment programs for substance abusers should include self-control training that targets behavior patterns such as anger proneness and impulsive responding. Wills, T.A., Sandy, J.M., and Shinar, O. Cloninger's Constructs Related to Substance Use Level and Problems in Late Adolescence: A Mediational Model Based on Self-Control and Coping Motives. Experimental and Clinical Psychopharmacology, 7(2), pp. 122-134, 1999.

Family History of Substance Use Disorder Moderates Relation between Cognitive Distortions and Aggressive Behavior and Aggressive Behavior and Drug Use for Adolescent Boys

The purpose of this study was to determine whether the relations between (a) cognitive distortions and aggressive behavior, (b) cognitive distortions and drug use, and (c) aggressive behavior and drug use are moderated by a family history of a substance use disorder (SUD) in adolescent boys. Participants were 165 boys aged 15-17 years with (FH+; N=75) and without (FH-; N=90) a family history of SUD. Results indicated that a family history of SUD moderated the relation between cognitive distortions and aggressive behavior and the relation between aggressive behavior and drug use. Family history of SUD did not moderate the relation between cognitive distortions and drug use; however, cognitive distortions were positively related to drug use within both groups. Giancola, P.R., Mezzich, A..C., Clark, D.B., and Tarter, R.E. Cognitive Distortions, Aggressive Behavior, and Drug Use in Adolescent Boys With and Without a Family History of a Substance Use Disorder. Psychology of Addictive Behaviors, 13(1), pp. 22- 32, 1999.

Adolescent School Experiences and Dropout, Adolescent Pregnancy, and Young Adult Deviant Behavior

Predictive effects of school experiences were studied over a 7-year interval in a random community sample of 452 adolescents, 12 through 18 years of age. Outcomes examined included dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse. Logistic regression showed academic achievement, academic aspirations, and learning-focused school settings to be related to a decline in deviant outcomes independent of the effects of disadvantaged socioeconomic background, low intelligence, childhood conduct problems, and having deviant friends during adolescence. Associations between school conflict and later deviancy were mediated by deviant peer relationships in adolescence and other school characteristics. Prior research reporting continuity of childhood conduct problems and the influence of adolescent affiliations with deviant peers on negative outcomes was supported. Implications for using the school context in risk factor research and the practical applications of such research for intervention are discussed. Kasen, S., Cohen, P., and Brook, J.S. Journal of Adolescent Research, 13 (1), pp. 49-72, 1998.

Interpersonal Aggression in Urban Minority Youth

This study examined perceived social environmental and personal control variables as predictors of interpersonal aggression in urban minority youth. Perceived environmental factors including neighborhood risk, friends' delinquency, and parental monitoring practices, were examined as direct predictors of aggression and as indirect predictors mediated by anger control skills and risk-taking characteristics. The sample consisted of 452 primarily African-American sixth graders attending New York City public schools. Results of structural equation modeling indicated that perceived higher levels of parental monitoring were directly associated with less aggression and had an indirect effect mediated through better anger control skills. Perceived neighborhood risk and friends' delinquency were directly associated with more aggression and were indirectly effected through greater individual risk-taking. Griffin, K.W., Scheier, L.M., Botvin, G.J., Diaz, T. and Miller, N. Interpersonal Aggression in Urban Minority Youth: Mediators of Perceived Neighborhood, Peer, and Parental Influences. Journal of Community Psychology 27(3), pp. 281-296, 1999.

Drug Use Among Puerto Ricans: Ethnic Identity as a Protective Factor

This study assessed the relationship of multiple drug risks, Puerto Rican identity, and drug use. Structured interviews were conducted with 555 Puerto Rican males and females whose mean age was 19. Each risk factor and two ethnic variables were related to drug use. Regressions showed that cultural knowledge, being culturally active, group attachment, and identification with Puerto Ricans offset the impact of risk factors on drug use. Ethnic variables also enhanced the protective effect of other protective factors. In sum, the results substantiate expanding risk-buffering models to include ethnic identity and the protective role of ethnic identity for Puerto Rican youth. Brook, J. S., Whiteman, M., Balka, E. B., Win, P. T., and Gursen, M. D. Journal of Hispanic Research, 20(2), pp. 241-254, 1998.

Vulnerability to Drug Use Among Latino Adolescents

In this study, risk and protective factor indices were developed to examine vulnerability to drug use among Latino high school students. Survey data were collected from 516 Latino 9th and 10th grade youth in the Los Angeles area. Frequency and quantity of use data were collected for cigarettes, alcohol, marijuana, inhalants, cocaine, and other illicit drugs. Few gender differences emerged in prevalence of drug use and about 25% were already involved in heavy drug use. Seventeen variables were examined for inclusion in a risk factor index (RFI) or protective factor index (PFI). Bivariate, multivariate, and structural equation models (SEM) were employed in the analysis of data. All of the variables except for one were more risk-inducing than protective for these Latino youth. However, as a group, the PFI predicted several types of drug use for boys and girls, and moderated the adverse effects of the RFI. At a high level of risk, a high level of protection was associated with reduced use for some types of drugs. In the SEM, vulnerability to drug use as indicated by the RFI and PFI was strongly associated with drug use for both boys and girls and more strongly related to drug use than the RFI or PFI alone. These results have exciting implications for intervention. Felix-Ortiz, M. and Newcomb, M.D. Journal of Community Psychology, 27(3), pp. 257-280, John Wiley & Sons, Inc., 1999.

Effect of Parent-Child Relations on Child Oppositional Behavior

This study is one of a series modeling sequences of intervention effects on parenting or family protective processes influencing various distal child outcomes. It was hypothesized that (1) positive parent-child affective quality would have a direct negative effect on child oppositional behavior both concurrently and across time, (2) that over time child oppositional behavior would have a negative effect on positive parent-child affective quality, and (3) that child's sense of mastery would have a negative effect on oppositional behavior. Data were obtained from family members participating in a family competency building intervention studies. The model was tested twice with independent samples. Sample one (n=171) participated in a pilot study of the Preparing for the Drug Free Years Intervention (PDFY); sample two (n=361) participating in a longitudinal evaluation of the PDFY. Attendance in the intervention was used as a control factor, with those in control groups being scored zero. Results of covariance structure modeling were generally consistent with the hypothesized model for both samples. Consistent with prior research, parent-child affective quality played a significant role in oppositional behavior. However, the opposite was not true in this general population study. That is, adolescent oppositional behavior did not have a strong negative effective on subsequent parent-child affective quality. There was also a weaker than expected relationship between sense of mastery and oppositional behavior. Spoth, R., Redmond, C., Shin, C., and Huck, S. A. Protective Process Model of Parent-Child Affective Quality and Child Mastery Effects on Oppositional Behaviors: A Test and Replication. Journal of School Psychology, 37(1), pp. 49-71, 1999.

Family and Peer Correlates of Behavioral Self-Regulation in Boys at Risk for Substance Abuse

A study at CEDAR focused on behavioral self-regulation (BSR), which was operationally defined as the degree to which one can control one's own activity and reactivity to environmental stimuli. BSR has been posited to be an important determinant of the onset of adolescent substance abuse. The goal of this study was to clarify particular family and peer correlates of BSR in at-risk sons. Subjects were 10-12-year-old sons of substance- abusing fathers (high-average risk [HAR]; n = 176) and normal controls (low-average risk [LAR]; n = 199). A BSR latent trait was developed using multiple measures and multiple informants. Analyses included separate hierarchical linear regressions for HAR and LAR groups. In the hierarchical linear model for HAR sons, family dysfunction and deviant peer affiliation were significantly associated with BSR, whereas for LAR sons, only peer affiliation was significantly associated with BSR. These findings suggest that empirical, theory-guided interventions to prevent worsening of BSR in HAR boys should address specific interpersonal family, and peer factors. Dawes, M., Clark, D., Moss, H. Kirisci, L., and Tarter, R. American Journal of Drug and Alcohol Abuse, 25(2), pp. 219-237, 1999.

Social Influence and Psychological Determinants of Smoking Among Inner-City Adolescents

Adolescent economically disadvantaged households appear at high risk for smoking. This study focused on a sample of economically disadvantaged adolescents attending New York City schools (N=1875). Longitudinal predictors of smoking from four domains (socio-demographic background, social influences, social and personal competence, and individual differences) were tested. Social influences to smoke from mothers and friends both predicted smoking one year later. Poor decision-making skills and low psychological well-being also predicted subsequent smoking. Results suggest that training adolescents to resist social influences to smoke, problem solve, make sound decisions, and to cope with psychological distress are key components for effective smoking prevention approaches. Epstein, J.A., Botvin, G.J., and Diaz, T. Social Influence and Psychological Determinants of Smoking Among Inner-City Adolescents. Journal of Child & Adolescent Substance Abuse, 8(3), pp. 1-19, 1999.

Marijuana Use Among Minority Youths Living in Public Housing Developments

Youths residing in public housing developments are at heightened risk for drug use. The purpose of this study was to develop and test a model of marijuana etiology with adolescents (N=624) residing in public housing. African-American and Hispanic seventh graders completed questionnaires about their marijuana use, social influences to smoke marijuana, and sociodemographic and psychosocial characteristics. Results indicate that social influences, such as friends' marijuana use and perceived ease of availability of marijuana significantly predicted both occasional and future intentions to use marijuana. Individual characteristics such as anti-marijuana attitudes and drug refusal skills also predicted marijuana use. The findings imply that effective prevention approaches that target urban youths residing in public housing developments should provide them with an awareness of social influences to use marijuana, correct misperceptions about the prevalence of marijuana smoking, and train adolescents in relevant psychosocial skills. Williams, C, Epstein, J., Botvin, G.J., and Ifill-Williams, M. Marijuana Use Among Minority Youths Living in Public Housing Developments. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 76(1), pp. 85-101, 1999.

The Role of Personal Relationships in Drug Resistance

Close Parent-Child Bond Mitigates Risks of Adolescent Drug Use and Delinquency

A study was conducted to identify general and differentiating risk and protective factors from domains of culture and ecology, peer, family, and personality, related to adolescent delinquency and marijuana use, and to examine the protective role of the parent-child mutual attachment in offsetting cultural and ecological risk factors, leading to less delinquency and marijuana use. The study design consisted of a cross-sectional analyses of interview data collected in Colombia. A total of 2837 Colombian adolescents, 12 to 17 years of age participated. Adolescents were interviewed in their homes. Independent variables included measures from 4 domains: culture and ecology, peer, family, and personality. The dependent variables were delinquency and marijuana use. Results show that several risk factors, such as tolerance of deviance and sensation seeking, were similarly related to both delinquency and marijuana use, suggesting that a common cause underlies the propensity to engage in different deviant behaviors. Some risk factors were more involved in delinquency and other risk factors were more highly related to the adolescent's marijuana use. Finally, when violence is endemic and illegal drugs are readily available, a close parent-child bond was capable of mitigating these risk factors, leading to less marijuana use and delinquency. The findings have implications for public health policy related to interventions in countries in which violence and drug use are prevalent. The results point to intervention procedures aimed at adolescents vulnerable to marijuana use and delinquency as well as efforts aimed at specific vulnerabilities in these areas. For example, reducing the risk factors and enhancing the protective factors for marijuana use and delinquency may result in less adolescent marijuana use and delinquency. Brook, J., Brook, D., De La Rosa, M., Whiteman, M., and Montoya, I. The Role of Parents in Protecting Colombian Adolescents from Delinquency and Marijuana Use. Arch Pediatr Adolesc Med, 153(5), pp. 457-64, 1999.